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Effect of nature based voice therapy in the separation from mechanical ventilation process of intensive care patients

Year 2019, Volume: 44 Issue: Supplement 1, 119 - 132, 29.12.2019
https://doi.org/10.17826/cumj.556065

Abstract

Purpose: The study was conducted to investigate the effect of nature-based sound therapy on patients during the separation from mechanical ventilator in a surgical intensive care unit.

Materials and Methods: This randomized was controlled experimental study conducted with 64 patients. The patients was divided into two groups as experiment (n =34) and control (n =34) group. Before separating from the ventilator, the eyes in the experimental group were closed and 30 minutes of nature-based sound therapy was applied. Patients' arterial systolic and diastolic blood pressures, heart rate, respiratory counts, oxygen saturation values, pain at both 0th and 30th minutes before and after each interventions and the 0th, 10th, 20th and 30th minutes of seperation from the ventilator, and anxiety levels were compared. Data were collected by personal information form, survey form, Face Pain Scale, Glaskow Coma Scale, Modified Smiley Face Scale, and Richmond Agitation-Sedation Scale.

Results: Clinical and statistically significant differences were found in the patients in the experimental and control groups for mean systolic and diastolic blood pressures, heart and respiration rates, administration methods and measurement times. Pain, agitation and anxiety levels of the experimental group were found clinically and significantly lower than the control group.

Conclusion: Nature-based sound therapy applied in the process of separating the surgical patients from the intensive care unit from the mechanical ventilation support is effective in maintaining the arterial blood pressure, heart rate and respiratory rate in the normal range, and reducing the pain and anxiety.


References

  • 1. Lee O K A, Chung Y F L, Chan M F, Chan W M. Music and its effect on the physiological responses and anxiety levels of patients receiving mechanical ventilation: a pilot study. Journal of Clinical Nursing Journal of Clinical Nursing 2005; 14 (5): 609–620. 2. Wunsch H, Linde-Zwirble W T, Angus D C, Hartman M E, Milbrandt E B, Kahn J M. The epidemiology of mechanical ventilation use in the United States. Critical Care Medicine 2010; 38 (10): 1947–53.3. Hetland B, Lindquist R, Chlan LL. The influence of music during mechanical ventilation and weaning from mechanical ventilation: A review. Heart & Lung: The Journal of Acute and Critical Care 2015; 44 (5): 416–425. 4. Savran Y, Başoğlu T. Role of anxiety during unsuccessful weaning. Turkish Journal of Medical and Surgical Intensive Care 2015; 5 (5): 43–46.5. Hess DR, Kacmarek RM. Mekanik ventilasyonun temelleri. Akademisyen Kitabevi, Ankara, 3. Basım, 2016: 112-249, 6. Aghaie B, Rejeh N, Heravi-Karimooi M, Ebadi A, Moradian S T, Vaismoradi M, Jasper M.Effect of nature-based sound therapy on agitation and anxiety in coronary artery bypass graft patients during the weaning of mechanical ventilation: A randomised clinical trial. International Journal of Nursing Studies 2014; 51 (4): 526–38.7. Saadatmand V, Rejeh N, Heravi-Karimooi M, adrisi S D, Vaismoradi M, Jordan S. Effects of natural sounds on pain: A randomized controlled trial with patients receiving mechanical ventilation support. Pain Management Nursing 2015; 16 (4): 483–492.8. Blackwood B, Alderdice F, Burns K, Cardwell C, Lavery G, O’Halloran P. Use of weaning protocols for reducing duration of mechanical ventilation in critically ill adult patients: Cochrane systematic review and meta-analysis. BMJ 2011; 342: 7237–7237.9. Koyuncu A. Weaning from mechanical ventilation and nursing. Turkish Journal of Thoracic and Cardiovascular Surgery 2011; 19 (4): 671-681.10. Dokuz Eylül Üniversitesi Hastanesi Pediatrik Yoğun Bakım Ünitesi Ventilatörden Ayırma Protokolü. Sayfa: 1/3 Yayın Tarihi: 07.2009. Erişim Adresi: http://web.deu.edu.tr/cocukyogunbakim/bakim/ventilatorden_ayirma.pdf. Erişim Tarihi: 12.10.2017.11. Kalkan G. Çocuklarda mekanik ventilasyon. Selçuk Tıp Dergisi 2013; 29 (3): 150-152.12. Çelik S. Erişkin yoğun bakım hastalarında temel sorunlar ve hemşirelik bakımı. Nobel Tıp Kitapevleri, İstanbul, 1.Basım, 2014: 49-50.13. Uyar M, Akın Korhan E. The effect of music therapy on pain and anxiety in intensive care patients. The Journal of The Turkish Society of Algology 2011; 23: 139–146.14. Twiss E, Seaver J, McCaffrey R. The effect of music listening on older adults undergoing cardiovascular surgery. Nursing in Critical Care 2006; 11 (5): 224-31.15. Bieri D, Reeve R, Champion GD, Addicoat L, Ziegler JB. The Faces Pain Scale for the selfassessment of the severity of pain experienced by children: Development, initial validation, and preliminary investigation for ratio scale properties. Pain 1990; 41: 139-150.16. McCaffery M. Choosing a faces pain scale. Nursing 2002; 32(5): 62. 17. Kim EJ, Buschmann MT. Reliability and validity of the Faces Pain Scale with older adults. International Journal of Nursing Studies 2006; 43 (4): 447-56.18. Temiz Z, Özer N. Ameliyat sonrası ağrı şiddetinin dört farklı ağrı ölçeği ile karşılaştırılması. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi 2015; 18: 4.19. Hicks C, von BCL, Spafford PA. The Faces Pain Scale-Revised: Toward a common metric pediatric pain measurement. Pain 2001; 93 (2): 173-183.20. Teasdale G, Allen D, Brennan P, McElhinney E, Mackinnon L. The Glasgow Coma Scale: an update after 40 years. Nursing Times 2014; 110: 12-16.21. Gazal G, Mackie IC. Distress related to dental extraction for children under general anaesthesia and their parents. European Journal of Paediatric Dentistry 2007; 8 (1): 7-1222. Sessler CN, Gosnell M, Grap MJ, Brophy GM, O'Neal PV, Keane KA, Tesoro EP, Elswick RK.Richmond Agitation-Sedation Scale: validity and reliabil ity in adult intensive care patients. American Journal of Respiratory and Critical Care Medicine 2002; 166: 1338-1344.23. Sılay F. Yoğun bakım ünitelerinde sedasyon-ajitasyon ve ağrı değerlendirmesinde kullanılan iki ölçüm aracının Türkçe’ye uyarlanması: Geçerlilik ve güvenilirlik çalışması. Ege Üniversitesi Sağlık Bilimleri Enstitüsü, İç Hastalıkları Hemşireliği Anabilim Dalı Programı Yüksek Lisans Tezi, İzmir, 2016. 24. Sessler CN, Grap MJ, Brophy GM. Multidisciplinary management of sedation and analgesia in critical care. Seminars in Respiratory and Critical Care Medicine 2001; 22: 211-225.25. Ely EW, Truman B, Shintani A, Thomason JW, Wheeler AP, Gordon S, Francis J, Speroff T, Gautam S, Margolin R, Sessler CN, Dittus RS, Bernard GR. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA 2003; 289: 2983-91.26. Almerud S, Petersson K. Music therapy a complementary treatment for mechanically ventilated intensive care patients. Intensive and Critical Care Nursing 2003; 19 (1): 21–30.27. Liang Z, Ren D, Choi J, Happ MB, Hravnak M, Hoffman LA. Music intervention during daily weaning trials—A 6 day prospective randomized crossover trial. Complementary Therapies in Medicine 2016; 29: 72-77.28. Savran Y, Başoğlu T. Mekanik ventilatörden ayrılamama sürecinde anksiyetenin rolü. Yoğun Bakım Dergisi 2014; 5: 43-46.29. Payas Aİ. Postoperatif ağrı tedavisinde opioid seçimi ve kullanımı konusunda doktor eğitimi ve eğitim öncesi ile sonrasında doktorların postoperatif ağrı konusunda eğitiminin etkisinin değerlendirilmesi. Gazi Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı Uzmanlık Tezi, Ankara, 201330. Hunter B, Oliva R, Sahler O, Gaisser D, Salipante D, Arezina C. Music therapy as an adjunctive treatment in the management of stress for patients being weaned from mechanical ventilation. Journal of Music Therapy 2010; 47 (3): 198-219.31. Chontichachalalauk J, Malathum PP, Kredboonsri C, Hanucharurnkul S.The effect of music therapy on anxiety, physiological responses, and weaning parameters in patients during weaning from mechanical ventilation. Ramathibodi Nursing Journal 2008; 14 (3):328-46.32. Jaber S, Bahloul H, Guétin S, Chanques G, Sebbane M, Eledjam JJ Effects of music therapy in intensive care unit without sedation in weaning patients versus non-ventilated patients. Annales Françaises d’anesthèsie et de Rèanimation 2007; 26 (1): 30–8.33. Tracy MF, Chlan L. Nonpharmacological interventions to manage common symptoms in patients receiving mechanical ventilation. Critical and Care Nurse 2011; 31 (3): 19–28.

Yoğun bakım hastalarını mekanik ventilasyondan ayırma sürecinde doğa temelli ses terapisinin etkisi

Year 2019, Volume: 44 Issue: Supplement 1, 119 - 132, 29.12.2019
https://doi.org/10.17826/cumj.556065

Abstract

Amaç: Araştırma, cerrahi yoğun bakım ünitesinde yatan hastaların mekanik ventilasyondan ayırma sürecinde uygulanan doğa temelli ses terapisinin etkisini incelenmek amacıyla yapıldı.

Gereç ve Yöntem: Bu randomize kontrollü deneysel araştırma 64 hasta ile yapıldı. Hastalar deney (n=34) ve kontrol (n=34) grubu olmak üzere ikiye ayrıldı. Ventilatörden ayırmadan önce deney grubundaki gözleri kapatıldı, 30 dakika doğa temelli ses terapisi uygulandı. Her iki uygulama öncesi ve sonrası hastaların arteriyel sistolik ve diyastolik kan basınçları, kalp atım hızları, solunum sayıları, oksijen satürasyonu değerleri, ağrı ve anksiyete düzeyleri karşılaştırıldı. Veriler; kişisel bilgi formu, veri kayıt formu, Yüz Ağrı Skalası, Glaskow Koma Skalası, Modifiye Edilmiş Gülen Yüz Skalası, Richmond Ajitasyon-Sedasyon Skalası ile toplandı. 

Bulgular: Deney ve kontrol grubundaki hastaların ortalama sistolik ve diyastolik arteriyel kan basınçları, kalp atım hızları ve solunum hızları, uygulama yöntemlerine ve ölçüm zamanlarına göre elde edilen bulguların, klinik ve istatistiksel açıdan anlamlı farklılık gösterdiği belirlendi. Deney grubunun ağrı, ajitasyon ve anksiyete seviyelerinin, kontrol grubuna göre klinik açıdan anlamlı olarak düşük olduğu belirlendi.

Sonuç: Bulgularımız, yoğun bakımda yatan cerrahi hastalarını mekanik ventilasyon desteğinden ayırma sürecinde uygulanan doğa temelli ses terapisinin arteriyel kan basıncının, kalp atım hızının ve solunum sayısının normal sınırlarda sürdürülmesinde, ağrı ve anksiyetenin azaltılmasında etkili olduğunu göstermiştir. 


References

  • 1. Lee O K A, Chung Y F L, Chan M F, Chan W M. Music and its effect on the physiological responses and anxiety levels of patients receiving mechanical ventilation: a pilot study. Journal of Clinical Nursing Journal of Clinical Nursing 2005; 14 (5): 609–620. 2. Wunsch H, Linde-Zwirble W T, Angus D C, Hartman M E, Milbrandt E B, Kahn J M. The epidemiology of mechanical ventilation use in the United States. Critical Care Medicine 2010; 38 (10): 1947–53.3. Hetland B, Lindquist R, Chlan LL. The influence of music during mechanical ventilation and weaning from mechanical ventilation: A review. Heart & Lung: The Journal of Acute and Critical Care 2015; 44 (5): 416–425. 4. Savran Y, Başoğlu T. Role of anxiety during unsuccessful weaning. Turkish Journal of Medical and Surgical Intensive Care 2015; 5 (5): 43–46.5. Hess DR, Kacmarek RM. Mekanik ventilasyonun temelleri. Akademisyen Kitabevi, Ankara, 3. Basım, 2016: 112-249, 6. Aghaie B, Rejeh N, Heravi-Karimooi M, Ebadi A, Moradian S T, Vaismoradi M, Jasper M.Effect of nature-based sound therapy on agitation and anxiety in coronary artery bypass graft patients during the weaning of mechanical ventilation: A randomised clinical trial. International Journal of Nursing Studies 2014; 51 (4): 526–38.7. Saadatmand V, Rejeh N, Heravi-Karimooi M, adrisi S D, Vaismoradi M, Jordan S. Effects of natural sounds on pain: A randomized controlled trial with patients receiving mechanical ventilation support. Pain Management Nursing 2015; 16 (4): 483–492.8. Blackwood B, Alderdice F, Burns K, Cardwell C, Lavery G, O’Halloran P. Use of weaning protocols for reducing duration of mechanical ventilation in critically ill adult patients: Cochrane systematic review and meta-analysis. BMJ 2011; 342: 7237–7237.9. Koyuncu A. Weaning from mechanical ventilation and nursing. Turkish Journal of Thoracic and Cardiovascular Surgery 2011; 19 (4): 671-681.10. Dokuz Eylül Üniversitesi Hastanesi Pediatrik Yoğun Bakım Ünitesi Ventilatörden Ayırma Protokolü. Sayfa: 1/3 Yayın Tarihi: 07.2009. Erişim Adresi: http://web.deu.edu.tr/cocukyogunbakim/bakim/ventilatorden_ayirma.pdf. Erişim Tarihi: 12.10.2017.11. Kalkan G. Çocuklarda mekanik ventilasyon. Selçuk Tıp Dergisi 2013; 29 (3): 150-152.12. Çelik S. Erişkin yoğun bakım hastalarında temel sorunlar ve hemşirelik bakımı. Nobel Tıp Kitapevleri, İstanbul, 1.Basım, 2014: 49-50.13. Uyar M, Akın Korhan E. The effect of music therapy on pain and anxiety in intensive care patients. The Journal of The Turkish Society of Algology 2011; 23: 139–146.14. Twiss E, Seaver J, McCaffrey R. The effect of music listening on older adults undergoing cardiovascular surgery. Nursing in Critical Care 2006; 11 (5): 224-31.15. Bieri D, Reeve R, Champion GD, Addicoat L, Ziegler JB. The Faces Pain Scale for the selfassessment of the severity of pain experienced by children: Development, initial validation, and preliminary investigation for ratio scale properties. Pain 1990; 41: 139-150.16. McCaffery M. Choosing a faces pain scale. Nursing 2002; 32(5): 62. 17. Kim EJ, Buschmann MT. Reliability and validity of the Faces Pain Scale with older adults. International Journal of Nursing Studies 2006; 43 (4): 447-56.18. Temiz Z, Özer N. Ameliyat sonrası ağrı şiddetinin dört farklı ağrı ölçeği ile karşılaştırılması. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi 2015; 18: 4.19. Hicks C, von BCL, Spafford PA. The Faces Pain Scale-Revised: Toward a common metric pediatric pain measurement. Pain 2001; 93 (2): 173-183.20. Teasdale G, Allen D, Brennan P, McElhinney E, Mackinnon L. The Glasgow Coma Scale: an update after 40 years. Nursing Times 2014; 110: 12-16.21. Gazal G, Mackie IC. Distress related to dental extraction for children under general anaesthesia and their parents. European Journal of Paediatric Dentistry 2007; 8 (1): 7-1222. Sessler CN, Gosnell M, Grap MJ, Brophy GM, O'Neal PV, Keane KA, Tesoro EP, Elswick RK.Richmond Agitation-Sedation Scale: validity and reliabil ity in adult intensive care patients. American Journal of Respiratory and Critical Care Medicine 2002; 166: 1338-1344.23. Sılay F. Yoğun bakım ünitelerinde sedasyon-ajitasyon ve ağrı değerlendirmesinde kullanılan iki ölçüm aracının Türkçe’ye uyarlanması: Geçerlilik ve güvenilirlik çalışması. Ege Üniversitesi Sağlık Bilimleri Enstitüsü, İç Hastalıkları Hemşireliği Anabilim Dalı Programı Yüksek Lisans Tezi, İzmir, 2016. 24. Sessler CN, Grap MJ, Brophy GM. Multidisciplinary management of sedation and analgesia in critical care. Seminars in Respiratory and Critical Care Medicine 2001; 22: 211-225.25. Ely EW, Truman B, Shintani A, Thomason JW, Wheeler AP, Gordon S, Francis J, Speroff T, Gautam S, Margolin R, Sessler CN, Dittus RS, Bernard GR. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA 2003; 289: 2983-91.26. Almerud S, Petersson K. Music therapy a complementary treatment for mechanically ventilated intensive care patients. Intensive and Critical Care Nursing 2003; 19 (1): 21–30.27. Liang Z, Ren D, Choi J, Happ MB, Hravnak M, Hoffman LA. Music intervention during daily weaning trials—A 6 day prospective randomized crossover trial. Complementary Therapies in Medicine 2016; 29: 72-77.28. Savran Y, Başoğlu T. Mekanik ventilatörden ayrılamama sürecinde anksiyetenin rolü. Yoğun Bakım Dergisi 2014; 5: 43-46.29. Payas Aİ. Postoperatif ağrı tedavisinde opioid seçimi ve kullanımı konusunda doktor eğitimi ve eğitim öncesi ile sonrasında doktorların postoperatif ağrı konusunda eğitiminin etkisinin değerlendirilmesi. Gazi Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı Uzmanlık Tezi, Ankara, 201330. Hunter B, Oliva R, Sahler O, Gaisser D, Salipante D, Arezina C. Music therapy as an adjunctive treatment in the management of stress for patients being weaned from mechanical ventilation. Journal of Music Therapy 2010; 47 (3): 198-219.31. Chontichachalalauk J, Malathum PP, Kredboonsri C, Hanucharurnkul S.The effect of music therapy on anxiety, physiological responses, and weaning parameters in patients during weaning from mechanical ventilation. Ramathibodi Nursing Journal 2008; 14 (3):328-46.32. Jaber S, Bahloul H, Guétin S, Chanques G, Sebbane M, Eledjam JJ Effects of music therapy in intensive care unit without sedation in weaning patients versus non-ventilated patients. Annales Françaises d’anesthèsie et de Rèanimation 2007; 26 (1): 30–8.33. Tracy MF, Chlan L. Nonpharmacological interventions to manage common symptoms in patients receiving mechanical ventilation. Critical and Care Nurse 2011; 31 (3): 19–28.
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Details

Primary Language Turkish
Subjects Intensive Care
Journal Section Research
Authors

Tülin Kurt This is me 0000-0002-5300-000X

Sevim Çelik 0000-0002-2016-5828

Publication Date December 29, 2019
Acceptance Date June 19, 2019
Published in Issue Year 2019 Volume: 44 Issue: Supplement 1

Cite

MLA Kurt, Tülin and Sevim Çelik. “Yoğun bakım hastalarını Mekanik Ventilasyondan ayırma sürecinde doğa Temelli Ses Terapisinin Etkisi”. Cukurova Medical Journal, vol. 44, 2019, pp. 119-32, doi:10.17826/cumj.556065.